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Impulsivity and Inhibitory Control in Normal Development and Childhood Psychopathology

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Impulsivity and Inhibitory Control in Normal Development and Childhood Psychopathology Developmental Psychology Copyright 1990 by the American Psychological Association, Inc. 1990, Vol. 26, No. 5, 710-720 0012-1649/90/$00.75 Impulsivity and Inhibitory Control in Normal Development and Childhood Psychopathology Russell Schachar Gordon D. Logan Department of Psychiatry University of Illinois The Hospital for Sick Children Toronto, Ontario, Canada Two experiments investigated the development and pathology of inhibitory control in children. Inhibitory control was investigated with the stop-signal paradigm, which is based on a formal theory of inhibition and directly measures the mechanism of inhibition. The ability to inhibit developed little after Grade 2, but subjects with attention deficit disorder with hyperactivity (ADDH) showed deficient inhibitory control. Their deficient inhibitory control was attributable to the subgroup of ADDH subjects with pervasive hyperactivity who had a more severe inhibitory deficit than did the situational hyperactive subgroup, the normal group, and the pathological controls. These studies reflect the utility of the stop-signal paradigm as a measure of inhibitory control. The concept of inhibitory control is central in theories of measure of inhibition exists. Instead, impulsivity is defined op- child development and in the definition and explanation of erationally (e.g, calling out in class or demonstrating an inabil- psychopathological disorders of childhood—in particular, of ity to plan performance on a maze task). Most frequently, im- attention deficit disorder with hyperactivity (ADDH; Douglas, pulsivity and inhibitory control are studied with laboratory 1983; Kogan, 1983; Milich & Kramer, 1984). Inhibitory control tasks that involve response uncertainty, careful planning, and is one of several processes that perform the executive functions slow responding. The most common measure is the Matching of the cognitive system. These functions determine how various Familiar Figures Task (MFFT; Kagan, Rosman, Day, Albert, & mental processes (e.g., encoding, recognition, retrieval) will Phillips, 1964). This task requires subjects to search a number work together in the performance of a task. Children need exec- of similar pictures for one that matches a criterion picture ex- utive control to choose, construct, execute, and maintain opti- actly. Fast and inaccurate performance on the MFFT is as- mal strategies for performing a task, as well as to inhibit strate- sumed to indicate impulsivity or lack of cognitive control over gies that become inappropriate when goals or task demands the execution of the response; the subject is believed to be un- change or errors occur (Logan, 1985). Deficient inhibitory con- able to delay a response in the course of analyzing the stimuli trol is revealed by impulsive behaviors such as responding be- and searching for the correct alternative. fore the task is understood, answering before sufficient infor- Studies using the MFFT indicate that as normal children mation is available, allowing attention to be captured by irrele- grow older, they develop longer response latencies and greater vant stimuli (i.e, distractibility), or failing to correct obviously accuracy (Salkind & Wright, 1977). In contrast, children with inappropriate responses. Poorly developed inhibitory control clinical disorders characterized by apparent impulsivity, such might account for impulsive behaviors of younger children and as hyperactive children (attention deficit disorder, ADDH), re- of children with various types of psychopathology. spond more quickly and make more errors (see Campbell, Despite the importance of inhibitory control in theories of Douglas, & Morgenstern, 1971). These differences are inter- child development and psychopathology, no widely accepted preted as evidence of deficient impulse control in hyperactive and younger children. Impulsive performance on the MFFT and other tasks such as the continuous performance task is a We would like to acknowledge the contributions of Diane Chajczyk, major argument for the hypothesis that deficient impulse con- Pat Fulford, Haraldene Phair, and Rosemary Tannock in the conduct trol is one of the basic problems of hyperactive children (Doug- of this study and the support of the Ontario Mental Health, Ruth Schwartz, and Canadian Psychiatric Research Foundations. The man- las, 1983; Douglas & Peters, 1979). uscript was prepared with the assistance of the Medical Publications Performance on these tasks, however, depends on factors Department, The Hospital for Sick Children, Toronto, Ontario, Can- other than cognitive impulsivity. For example, MFFT perfor- ada. mance varies with IQ (Milich & Kramer, 1984); search strategy Correspondence concerning this article should be addressed to Rus- (Ault, Crawford, & Jeffrey, 1972); metacognitive awareness of sell Schachar, Department of Psychiatry, The Hospital for Sick Chil- appropriateness of inhibiting the response until all variants dren, 555 University Avenue, Toronto, Ontario, Canada, M5G 1X8 or to Gordon D. Logan, Department of Psychology, University of Illinois, have been compared (Brown, Bransford, Ferrara, & Campione, 603 East Daniel Street, Champaign, Illinois 61820. Electronic mail 1983); or decision criteria, motivation, or attentional capacity may be sent to g-logan @ h. psych, uiuc. or to attn @ sick kids, utoronto. (Kahneman, 1973). Consequently, the impulsivity that the MFFT and similar tasks reveal in younger and hyperactive 710 IMPULSIVITY AND INHIBITORY CONTROL 711 children could be accounted for by deficits in one or several times of these processes are assumed to vary randomly, the processes. Tasks like the MFFT may help distinguish between outcome of the race is a matter of probability. Thus, in the individuals or groups but do not clarify the underlying psycho- model, the main dependent variable is the probability of inhibi- logical processes that produce impulsivity. tion. In addition to difficulties in measuring impulsivity, clinical The main independent variable is the interval between the studies have been hampered by a lack of diagnostic precision. stop signal and the primary-task response (i.e, the stop-signal Many studies of impulsivity in hyperactive children have used delay). The stop-signal delay handicaps the race, biasing it in samples of children exhibiting a variety of comorbid disorders favor of one process or the other. If the signal occurs early or have not included pathological controls. Hyperactive chil- enough (i.e, well before the primary-task stimulus), subjects dren typically present with a variety of other disturbances, such will inhibit every time. If it occurs late enough (i.e, after the as conduct and learning disorders. To determine whether hyper- response to the primary task), subjects will never inhibit. Be- activity rather than one or all of these correlated disorders is tween these extremes, the probability of inhibition diminishes associated with cognitive impulsivity, hyperactive children gradually from 1.0 to 0.0. Plotting the probability of inhibition must be compared with children who have one of these dis- against stop-signal delay generates an inhibition function orders, as well as with normal children. whose shape depends on the distribution of primary-task reac- In this study, we investigated the development and pathology tion times and the distribution of internal reaction times to the of inhibitory control through the use of a new stop-signal para- stop signal (the stop-signal reaction time, or SSRT; for a formal digm that allows direct assessment of inhibitory control. In the derivation, see Logan & Cowan, 1984). first experiment, we focused on the development of inhibitory Differences in the efficiency of the inhibition process will control in normal children as measured in the stop-signal para- affect the shape of the inhibition function. In general, the better digm. In the second experiment, we compared the inhibitory the process, the higher and steeper the function. If the inhibi- control of normal children with that of children who have a tion mechanism were never triggered in stop-signal trials, the psychopathological condition characterized clinically by poor probability of inhibition would be 0.0 at all delays, producing a impulse control (ADDH). To determine whether a deficit in flat, low inhibition function. If the mechanism were triggered inhibitory control is specific to ADDH, we compared the per- in only some stop-signal trials, the function would be steeper formance of these children with that of children who have emo- and higher, but not as steep and high as a normal one. The speed tional, learning, and conduct disorders. of the inhibition mechanism also determines the shape of the inhibition function. A slower mechanism will lose the race against the primary-task process more often than a faster one, The Stop-Signal Paradigm producing a lower probability of inhibition. Extended over all The stop-signal paradigm is a laboratory analog of a situation delays, it will produce a lower and flatter inhibition function. If requiring inhibitory control that distinguishes stimuli that the inhibition mechanism of younger children or children with elicit impulsive behavior (primary-task stimuli) from those that a clinical condition affecting impulse control is less likely to be inhibit .it (stop-signal stimuli). Subjects engaged in a primary triggered, is slower, or is less consistent, their inhibition func- task (e.g., forced-choice letter discrimination) are presented tions will be flatter and lower than those
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